Chromium and zinc contamination of parenteral nutrient solution components commonly used in infants and children.
Chromium and zinc contamination of components of parenteral nutrient (PN) solutions used in infants and children was studied. Solutions of amino acids, L-cysteine hydrochloride, dextrose, electrolytes, minerals, vitamins, multiple trace elements, and individual trace elements were obtained. A variety of manufacturers, lots, and expiration dates were represented when possible. The solutions were analyzed for chromium and zinc by flame atomic absorption spectrophotometry. In all amino acid products, chromium concentration was below the limit of detection and zinc concentration ranged from 0.06 to 4.97 mg/L. In the L-cysteine hydrochloride products, chromium was measurable in only two lots (0.11 and 0.23 mg/L); zinc was measurable in all lots (32-86 mg/L). Sodium and potassium salts of chloride and acetate had chromium concentrations of 0.02-0.23 mg/L and zinc concentrations of 0.35-0.56 mg/L. Phosphate salts contained chromium 0.39-0.44 mg/L and zinc 0.91-2.33 mg/L. In calcium gluconate, zinc concentration was 0.28-2.38 mg/L. In four lots of multiple trace elements, chromium was 92-104% and zinc was 100-113.5% of the labeled amount. A PN solution for a < 10-kg infant compounded from the components assayed would provide up to an additional 0.7 microgram of chromium per kilogram and 200 micrograms of zinc per kilogram. Zinc and chromium contaminants were detected in many of the products that are common components of PN solutions for infants and children; the contamination may be sufficient to result in the administration of zinc and chromium in amounts exceeding current recommendations.
Hak
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Department of Clinical Pharmacy, University of Tennessee, Memphis 38163, USA. ehak@utmem1.utmem.edu
Storm
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MC
Helms
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D002648:Child; D002675:Child, Preschool; D002857:Chromium / Q000009:adverse effects* / Q000032:analysis; D004340:Drug Contamination; D004349:Drug Packaging; D004356:Drug Storage; D006801:Humans; D007223:Infant; D007225:Infant Food / Q000592:standards*; D010288:Parenteral Nutrition / Q000592:standards*; D019999:Pharmaceutical Solutions / Q000032:analysis; D015032:Zinc / Q000009:adverse effects* / Q000032:analysis
D019999:Pharmaceutical Solutions; D002857:Chromium; D015032:Zinc